UNIT 1 - AYUSH under Healthcare system and law in India

This ppt is about AYUSH and its role in healthcare system in India

1. UNIT 1 - AYUSH Ms.R.YUVANAA PRIYADHARSHINI SOL, SASTRA

2. INTRODUCTION - AYUSH  India is a land of great ecological, cultural, political and economic diversity. Its healthcare system reflects this diversity, both in its plural systems of health knowledge and practice. AYUSH is an acronym term that is composed of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa- Rigpa and Homeopathy. The term AYUSH is a Sanskrit term that denotes life or longevity. A separate Department of ISM&H (Indian system of medicine and homeopathy) was created in Ministry of health and family welfare in march 1995. Later it was renamed as department of AYUSH in November 2003. Department of AYUSH was upgraded to Ministry of AYUSH in November 2014 – Current minister of AYUSH - Shri Jadhav Prataprao Ganpatrao. There are around eight lakh of AYUSH practitioners, and even more local healers of in India.

3. THE DRUGS AND COSMETICS ACT, 1940 governs the AYUSH medicines and drugs – GMP ( Good manufacturing practices), Labelling requirements, Prohibition of misleading advertisements etc. and NMC Act as well. Technical Advisory Board: The Ayurveda, Siddha, Unani Drugs Technical Advisory Board (ASUDTAB) advises the central and state governments on technical matters related to these medicines.  Consultative Committee: The Ayurveda, Siddha, Unani Drugs Consultative Committee (ASUDCC) works to ensure uniformity in the administration of the Drugs and Cosmetics Act and Rules across the country.  Ethical Violations: The National Commission for Indian System of Medicine (NCISM) has guidelines and regulations for AYUSH practitioners, including ethical guidelines. Violations of these guidelines, such as misrepresenting qualifications or producing fake certificates, can result in warnings, suspension, or permanent removal from the register. 

4. Indian Penal Code: Section 419 (cheating by impersonation) and Section 420 (cheating and dishonesty), Sec 304-A for criminal negligence can also be applied to cases involving fake doctors and in case of death of patient. Currently in BNS – Sec 318, Sec 319 and sec 106 respectively. Non registration by Ayush practitioners would attract Rs.25,000 for 1 st offence, Rs. 2L and 1 year imprisonment for 2 nd offence and Rs 5L and 3 years imprisonment for 3 rd offence under The Clinical Establishments (Registration and Regulation) Act, 2010 Minister for Health, Medical Education and Family Welfare Y. Satya Kumar Yadav has given powers to 13 government AYUSH doctors to take action, as per Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954 , against people for publishing misleading advertisements with regard to the use of traditional medicines.

5. KARNATAKA FAKE AYUSH PRACTITIONERS Following a notification from the state government, the board officials conducted raids at 94 ayurvedic clinics across the state and filed cases against 15 fake Ayush doctors. The quacks did not have their registration numbers and degree certificates. Shettigar , who led the raids, said, “The raids were conducted randomly and of the 34 fake Ayush practitioners, who we suspected as fake, we could catch hold of only 15. https://www.deccanchronicle.com/131127/news-current-affairs/article/ayush-board-draws-stiffer-penalties-fake-doctors

6. 1. AYURVEDA   'Ayur' means age and 'Veda' denotes knowledge, so Ayurveda defines knowledge about age or the knowledge which describe age. The knowledge of Ayurveda is claimed to have passed down to humans through a chain of supreme beings. Oldest references of Ayurveda are found in Atharvaveda that is last of four principles text of Hindu philosophy. Major Principles of Ayurveda are. 1. Tridosha 2. Triguna 3. Saptdhatu 4. Panchmahabhoot 5. Biofire (Agni)

7. The principal objectives of Ayurveda is maintenance and promotion of health, prevention of disease and cure of sickness Health is considered as a state of balance of tridosha , triguna in body matrix. Diagnosis of disease is achieved by taking care of various internal and external factors altogether, by means of treating body as a whole. The treatment of disease can be achieved by: Nidan Parivarjan (Avoidance of factor, causing disease) Shodhana therapy (Purification Treatment) 3. Shamana therapy (Palliative Treatment) 4. Pathya Vyavastha (Prescription of diet and activity)

8. Degree awarded for graduation BAMS – Bachelor of ayurveda, medicine and surgery ( Ayurvedacharya ), post graduation MD(Ayurveda vachaspati ) in 14 subjects, Kayachikitsa , Agad Tantra, Dravya Guna, Kaumar Bhritya , Maulik Siddhanta, Panchakarma, Prasuti Tantra & Stri Rog Roga & Vikrit Vigyan, Rasa Shastra, Sharir Rachana, Sharir Kriya, Shalya Tantra, Shalakya Tantra, Swastha Vritta . Regulatory body for education and practice CCIM – Central council of Indian medicine(1970). (Dissolved in 2021 and replaced by NCISM – National commission for Indian system of medicine) Research council CCRAS – Central council for research in ayurvedic sciences Apex institutions NIA Jaipur, AllAS Delhi, ITRA Jamnagar. World Ayurveda Day – September 23.

9. 2. YOGA The literal meaning of the Sanskrit word Yoga is 'Yoke'. According to Maharishi Patanjali (The Father of Yoga), Yoga is the suppression of five modifications of the mind Yoga is one of the six systems of Astik Vedic philosophy. Maharishi Patanjali, compiled and refined various aspects of Yoga systematically in his "Yoga Sutras". He advocated the eight folds path of Yoga, popularly known as "Ashtanga Yoga" for all-round development of human beings Yoga is universal in character. Yoga is a process for the development of human consciousness. Types of yoga Japa Yoga-To concentrate one's mind on divine name or holy syllable, mantra etc. Karma Yoga-Teaches us to perform all actions without having any desire for their fruit. Gyana Yoga-Teaches to discriminate between self and non- self and to acquire the knowledge of one's spiritual entity.

10. Bhakti Yoga- A system of intense devotion with emphasis on complete surrender to divine will. Raja Yoga-Raja Yoga popularly known as Ashtanga Yoga Swara Yoga- Swara Yoga involves the systematic study or the breath flowing through the nostril. Kundalini-Kundalini Yoga is a part of Tantric Tradition. And it involves awakening of potential force residing in Muladhara chakra. Nadi- Nadis are flow of energy which we can visualize at the psychic level as high voltage channels conducting the energy to the chakras.

11. 3. NATUROPATHY Naturopathy is an art and science of healthy living and a drugless system of healing. The morbid matter theory, concept of vital force and other concepts upon which Naturopathy is based are already available in old texts. The revival of Naturopathy started in India by translation of German Louis Kuhne's book "New Science of Healing“ (1917). Naturopathy is a system of man building harmony with the constructive principles and forces of Nature. It has great health promotive, disease preventive and curative as well as restorative potential and effect.

12. Types of Naturopathy:- 1. Diet Therapy 2. Fasting Therapy 3. Mud Therapy 4. Hydrotherapy 5. Masso-Therapy 6. Acupressure 7. Acupuncture 8. Chromo Therapy 9. Air Therapy 10. Magnet Therapy

13. Yoga and Naturopathy Degree awarded BNYS (Bachelor in Naturopathy and Yoga Sciences) are called Doctor of yoga and naturopathy. While BA, BSc, MA, Msc in yoga are considered as yoga professionals. In India, as of January 1, 2023, there were 4,379 registered practitioners in Naturopathy. Apex institutions NIN Pune and MDNIY- Morarji Desai National Institute of Yoga, Delhi. Research councils CCRYN- Central council for research in yoga and naturopathy, Delhi. World yoga day - 21 June.

14. 4. UNANI Unani system originated in Greece. The foundation of Unani system was laid by Hippocrates. In India, Unani System of Medicine was introduced by Arabs and Persians sometime around the eleventh century. Four humors balance theory.(Dam (blood), Balgham (phlegm), Safra (yellow bile) and Sauda (black bile). Seven components makes human body. They are : Mizaj (Temperament), Akhlat (Humors), Aaza (Organs), Arwah (Spirits), Quwa (Faculties), Afaal (Functions), Arkan (Elements)

15. The Diagnostic process in Unani system is dependent on observation and physical examination. Any illness of a person is to be regarded as a product of: 1.The kind of temperament, and strength of faculties he has; 2.The type of factors operating on him from outside. Unani medicine has the following main types of treatment 1.Regimental therapy (Ilaj- bil -Tadbir) 2. Dieto therapy (Ilaj- bil - Ghiza ) 3.Pharmacotherapy (Ilaj- bil -Dawa) 4.Surgery (Ilaj- bil -Yad) Research council CCRUM – Central council of regional research institute of Unani medicine Regulatory council CCIM – Central council of Indian medicine World Unani Day – February 11

16. Degree awarded BUMS Bachelor of Unani medicine and surgery(Kamil-e-tib-o- Jaraha ), post graduation Mahir-e-Tib (Doctor of Medicine) and Mahir-- Jarahat (Master of Surgery) in eight disciplines; Moalajat (Medicine), Ilmul Ac (Pharmacology), Tahaffuzi wa Samaji Tib (Preventive and Social medicine), Ilmul Qabalat wa Amraze Niswan (Obstetrics & Gynaecology), Ilmul Saidla (Pharmacy), Kulliyat (Basic Principles), Ilaj bit Tadbeer ( Regimenal Therapy), Ilmul Jarahat (Surgery). Apex institutions National Institute of Unani Medicine (NIUM) Bangalore.

17. 5. SIDDHA Siddha system is one of the oldest systems of medicine in India. The term Siddha means achievements and Siddhars were saintly persons who achieved results in medicine. Siddha literature is in Tamil and it is practiced largely in Tamil speaking part of India and abroad. The Siddha System is largely therapeutic in nature. According to its tradition it was lord Shiva who unfolded the knowledge of Siddha system of medicine to his concert Parvati who handed it down to Nandi Deva and he then to Siddhas. The principles and doctrines of this system, have a close similarity to Ayurveda, with specialization in iatro-chemistry. According to this system the human body is the replica of the universe and so are the food and drugs irrespective of their origin. This system considers the human body as a conglomeration of three humors, seven basic tissues waste products of the body (feces, urine and sweat.)

18. The Siddha system of capable to treating all types of disease other than emergency cases especially skin and venereal diseases. Siddha graduates with B.S.M.S Siddha Maruthuva Arignar (Bachelor of Siddha Medicine and Surgery). Post graduation Siddha Maruthuva , M.D. (Siddha) course i Siddha Maruthuvam Pothu (General Medicine), Gunapada (Pharmacology), Pillaippini Maruthvam ( Paediatrics ), Noi nadal (Pathology), Sirappu Maruthuvam (Special Medicine), Nanju nool (Toxicology). Apex institutions - NIS Chennai. Research council CCIM Delhi. World Siddha Day – December 19

19. 6.HOMEOPATHY Homoeopathy is the youngest of all these medicinal systems  yet rapidly growing and is being practiced almost all over the world. The word 'Homoeopathy' is derived from two Greek words, Homois meaning similar and pathos meaning suffering. It is based on the natural law of healing- " Similia Similibus Curantur " which means "likes are cured by likes". It was given a scientific basis by Dr. Samuel Hahnemann ( 1755-1843) in the early 19th century. During illness the whole person is in a state of imbalance. Homeopathic remedies are potentized substances carrying information/energy force that acts on vital force. Once that vital force is balanced, the person gets healed.

20. Homeopathic medicines are bio-energetic substances with similar resonance or vibration, matched to the person's state of imbalance. Homeopathic remedies are diluted beyond Avogadro's number so there are no chemical side-effects. Potentization- Highly diluting a substance in alcohol or distilled water, stirring it a fixed number of times in precise directions and striking a pestle against a mortar certain times. Two types of treatments 1. Acute, 2. Chronic Graduate degree BHMS(bachelor of homeopathic medicine and surgery). Post graduation in MD ( hom ) with specialization's Materia Medica, Organon of Medicine and Philosophy, Case Taking and Repertorisation , Practice of Medicine, Psychiatry, Paediatrics. Apex institution NIH Kolkata –National Institute of homeopathy Research council CCRH Delhi – Central council for research in homeopathy Regulatory body CCH Delhi – Central council of homeopathy

21. 7.SOWA-RIGPA Commonly known as Amchi system of medicine is one the oldest, Living and well documented medical tradition of the world." Sowa-Rigpa " (Science of healing). Gyud -Zi (four tantra) the fundamental text book of this medicine It has been popularly practice in Tibet, Magnolia, Bhutan, some parts of China, Nepal, Himalayan regions of India. Some scholars believe that it is originated from India, some says China and others consider it to be originated from Tibet itself The first Ayurvedic influence came to Tibet during the 3rd century AD but it became popular only after the 7th centuries with the approach of Buddhism to Tibet. The majority of theory and practice of Sowa- Rigpa is similar to "Ayurveda". Jung- wa - nga ( Panchamahabhutas ); viz Sa, Chu, Me, Lung and Nam-kha (Prithvi, Jal, Agni, Vayu and Akash) Ngepa - Sum ( Tridosa ). In most of Himalayan regions Sowa- Rigpa is practiced in traditional ways with community support with an Amchi in every village.

22. There are all together around 1000 practitioners of Sowa- Rigpa in India catering health care in harsh Himalayan regions. Sowa- Rigpa was included in Indian AYUSH therapies in 2010. The nomenclature of this six years course is Bachelor in Tibetan Medical System, Kacupa (BTMS) or Amchi Chikitsa Acharya. This course is presently conducted in four Institutions in India. Post graduation ' Tsojed Menrampa , (MD) & Sojed Menrampa (MS) Specilzations - TaGrub (Fundamentals/ BasicPrinciples ), Rota (Human Anatomy), Lu sKyi gNes Lugs (Human Physiology), gSo Tha (General Medicine), Byis Pa Dang Mo Nad (Paediatrics & Gynaecology), Sems Khams Rig Pa (Human Psychology ana Psychiatry), brTag Thabs (Pathology), sByor Wa sMen (Pharmacology), 'Jam rTsub dPyad (Surgery), Tha Mal Nad Med (Preventive Medicine) Central council for Tibetian medicine CCTM Dharmshila , H.P. Apex institution Central University of Tibetan Studies, Sarnath, Varanasi.

23. IMPORTANCE OF AYUSH IN PUBLIC HEALTH The potential of Ayurveda drugs to tackle community health problems resulting from nutritional deficiencies, epidemics and vector-borne diseases has been widely recognized Some of the drugs have been included in ASHA kit (About accredited social health activist) for first hand management of health problems at village level ( Punarnavadi Mandura ). Ksharasutra therapy for anorectal disorders. Rasayana Chikitsa (rejuvenation therapy) for senile degenerative disorder i.e. dementia Panchakarma therapy unit mentioned in the PIP ( Program implementation plan) AYUSH health programs - School Yoga program and Yoga camp by Orissa, Punjab and Andhra Pradesh. Rajasthan-" Suposhanam " a community nutrition program for tribal women with Ayurveda mobile units. Outreach activities - Jharkhand, Himachal Pradesh, Jammu Kashmir, Uttarakhand and Orissa- AYUSH doctors in mobile medical units. Madhya Pradesh and Tripura- AYUSH call center in their PIP. Establishment of AYUSH epidemic cell - Tamil Nadu and Kerala-prevention and control of epidemics. Local health traditions - Activities like Ayurved Gram by Chhattisgarh "Dadi Maa Ki Batua " in Jammu and Kashmir. "Gyan Ki Potli ," by Madhya Pradesh.

24. ISSUES WITH AYUSH Absence of cross referral systems. Lack of acceptable scientific evidence. Cross practice. Undemocratic pluralism. Mirrored growth despite parallel growth, with the modern medicinal system. Pharmaceuticalisation of AYUSH and LHT (local health traditions).

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